02040086 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT 'CONTRACTOWINF'ORMATION- .
6.
BUILDING ADDRESS: PERMIT NO.
7763 UIREHILL CT SCHAUMANN AIR CONDITIONI G, 02040086
OWNER'S NAME: APPLICATION SUB DATE
STACHNICK GREGORY L AND ISAB L HEATING & PLUMBING INC 04/17/2002
PHONE: SANITARY N0, CONTROL N0.
(408) 428-0640
q 0 p ARCHITECi/ENGINEER: BUILDING PERMIT INFO
kC BLDG ELECT PLUMB MECH
t6�
ii LICENSED CONnRACnderp DECLARATION
w IhenbyaRnn witiam licensed lsircrpmdaiomorChapm9gommenense Job Description
with lif ]0001 of Oirision3of she Businos and Pmfesxions Coda.and my license FURNACE & ADD A/C UNIT.
Y irinr01cone,M f�s�� 77GYJ,�/L (3 . 5 TON A/C UNIT)
om< Licen.Class W`6 Lit.L
u Daml Commnor
LL O RCHITECrS DECLARA :J
i 5 1 understand my plans shall he,used as public records
p o Licensed Professwaal
Q,(= OWNER-BUILDER DECLARATION
I hereby olfirm that I am exempt fmm the Contractor's License law for the
t K< following reason.(Section 703M.Business and Professions Cade:Any city or county
IF O which requires a permit to construct.alter,improve.demolish,or repair any structure
to ,pri«t !.issuacSalw mquimumhebapplicant fonuch permit ale.si{ncd bue.m __ _ _ ..
tiht Ile s 1 censM uuentw UK tions of Ne Convxmis 4cense lsw(Geµer 9
(tamer sec. 7000 of r S E[IFloor ,, e - Valuation
e srN ou mn3armeea �.naPakpemn,cMe> !:(-!'` Q.. .,q g5t19 ` l;:r,� ;
Or that he a exempt tl<rcfrom sod the basis for the alleged .a unpiron.Any rrolauon
-of Stallion 70713 by any.Pplleant fora permit subjects rhe opplicansw eeivll'penahy-
:ora moredad R,ea hundred dmldn(S300). um er �r"Rvr.:r,, Occupancy Type
❑1, ownu or Ne propcnY•ur mY cm lac wire wages utMir wl<nmpcwsion, _
-1361"a rh-'oro;. i she n n Can
ncr ...deicer License Law for,not p,l.706x,-" 3 0 3 - ROUGH M1S9I�'§'p4tions't'-
Basi ssro Rofe tion CMe The Comrcm s. adw law docs not apply m on
o1 th f p pony Who Ids . proves at d emdoe e n work himself
onhrou{h M1aweemployees,e b den 6 t such r _p tame sa e of intended o „3,0.4 - ROUGH ELECTRICAL _
offered rot sale.1(,liowcvcr.Nc builan o t u sold iA o e __._._.... . .__.._ -__-,_
edmleren.Neowner.wilaerwrnhavettirebard.ar y"ref 505 - FINAL ELECTRICAL,' T'`" v -.:f. . -
D provin{that he dumas build or
improve for pumo+c of vlc.). 507 - FINAL_ PLUMBING
-- ----------.........- -- -------- — --------- ---
0L..crwmerOfthe rort,amndu,ivel cornsatsin .___ __- __. .. _ -___.-,._...._.-._._.-_._._..__.._.
= tonsvua the project(sic.i0xx,Business and Profaas ons Code Tno Convactoor's 5 0 8 - FINAL MECHANICAL_.._.._...-:iTL Isn PESC•:;.-1>:'f,
License law docs not apply Io an owner of property who Guilds or improves thereon, ® "�"' - -
/� M r..aa a....
-?,t. .aM.who.canuacu.for,. projecu.with.a.comractor(s),IkevsM.pusauam-13.613_ ..._.—.— =IN ligeppr.___._,-_.._._.._.._..._..______..-______,___
Conuac. r License Lava, .l i i .F C ,v
Olamuc W Mer Sec "BAPcfa Nu rcuon r rS00eL '.`it 1. "i.,11011,
o nom; Dai 'PR 2 J L L
WORKER'S COMPENSATION DECLARATION
-1 hereby.M.order of perjury' ooe o(NcfollowinY dMuations:-
Cmci woel6iufaWrer',❑ 1wmanuins.'CBUILDING
:i Compensation:;or gaddM for-by Smion-1700'of-rhe'Iabor CMe,-for Ne
-_ perfundntt e'wo
aof Nrk for which Nis pemul,u issueA.....r
j '. ❑1 react 6116 11 melaw W rke 6 COmpenNr O Sni 'rr¢,a,'I�arrtd byb'KllOn
3700 of the Labor CMe for.rte perfmmmtt of Ne work'fa h ch Nu pe'rmrt rs
ssucd Workers C pens on InsuresKe c r M Poli number art '
Cattle
'
CON'
i i v { pr 11�1�;1.♦ tAt t.trl .:1LaT101t..
S arty -p
" 9 c e CERTIFIQATION OF EREMPf10N FROM WORKER$g � .. . .. ,t.J R -\
'' y COMPENSATION WSURANCB " " _
Oat\ _\( .).
fi' (ITrs ienron rrleed nor bc'i'ampleied if the perms n(or one huMnd dollus I
ISI00)or las.)i's.n%.cry... np...v.:. `::S r..rc..t a:vs•�a.o-y c...:M1..n
f� jl eenfy Ws'h Ne pert nn CC Of Ne work-fo heh Nspersmili yM,'I ..e, l :' , -I.. (...t'�y l:': :•Ss.B O\'f.._--._..
shall na pl y ony,person 1 any nunnel so sobedome wEjed w Ne`Worken,
Compehut on laws of Cahforma Due
NO TItEYOAPPLICANT If ofmr mo ng shu Cenl cine of Exempo ou should
Z became subject w Ne Work is Co pdhsition pros tri of Ne lana Code.you must '
O ! M1 N comply-with such provisions or this pc s hall rte dttmedked 7�Tom. `
6 .
, ,+ ! ?. �
F y -.; CONSlRUC710N LENDING Ingle Y
hereby whTh Nat N 1 e conitmct o lend ng ag racy fa Ne peRormanc =f
W �Ne wok fo h eh N pc (t a r,saed'(Sec 3097_ C) 1 y . , APD r� -
L Leudet
O Lta I C
U
x,lh IcenfyN tihav< MN vpinto ami Na Nc bst fwstehi l,
IT+;:U to nca 1 a{rt ,r comply wnh.e6 city end ry qrd t ccs M t u 1 .t..png
0 V to bu6drnL mna -a on ands rcbY wNorive rcprtxnutryesoPous<ny wemer upon
�+ L,7 th<aboveme t n
t.ny liebil t s,JpdYndp!op. f f, dm
of penlno gun
tL IWetag..wave hfi2rNorfy and keephuazmlessC e _
nu.
cosu anniespemse,.uh en may iv atry;w y acme e{ururuid I
U Z Cirymconsequ rete of int gtaJnjp.y bf msDerrnst'
APpt1con YD$R3Y 'PgN"DW14GCO\t�l,Yi,'fii AL 0\ LNT" r O
Issued by: Date
b In
hyl7�
5. on Pheaar72Fo uan r t IS Pao yp.
b•! - S MATERIALS D73CLOSURE � 'l !t � Re-roofs
?p WII'Ne epphnnt budding occupant nwco.heMla haunim,material .T e.of Roof - - -- - --
u de0ned by thatC pen t.Municipal.CMe Chapter9 11 and she Health sold Safety
Cade Secwn 83331.17 -r v (
I '• i s i ( t }' r .I
v i124 kt ,.
Cl Ye, ..',�, No ,.All.roofs.shall.be inspected pnor.to.any roofing.matenal being installed...
,c W01th ,apprterelwfmnwldinj«npontuwcquipr ntade,icnwb.ch If a roof is installed Without first obtaining ani ins peenon,'-I 'ag�eeto'remove
emit haaardoui au cmalurnnenu as defned b)the Bey Arta Ar QiltyuMa ijabm t
District - -. .,all new materials for,inspection._ Applicant understands and,will comply with
t,l pYes all non-point source regulations.. tit( - ...•;
L` Pi .r. .
Ca'l'l,1ha rofreM�ihei havardousmaan rcgorreme3talder Chapuc693of the '
Calif is d:Safety Cn Sections 231.that 3333aM83Nbbtyto uM Net
if N'e baildiny daei-nm currtnlly have<senonvNas h is mY.nspovsibility.o notifyNe
Occupant of Ne qui,A u silt mastbe t pia to mu e i ifrcate"of
_Signature of Applicant-_...- _.. .. _ Date
a a na. ag t nae f,. All roof coverings to be Class'B or better `I
=-I"" ..
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